"Were it not for uncertainty surrounding the future of the ACA, Horizon would be proposing a single-digit rate increase", Horizon spokesman Kevin McArdle said. This, of course, would increase the out-of-pocket costs borne by consumers and potentially send the healthcare exchanges (i.e., the online marketplace) into the death spiral that all of us keep hearing about. This is assuming insurers knew by the end of August that the payments would end after December, CBO staff said.

This aspect of the law is created to attract healthier Americans and offset the costs of treating the sickest people, thereby keeping premium costs down. The loss of the $7 billion payments would cause the federal deficit to rise by $6 billion in just one year, and $195 billion over the next decade. "Congress owes struggling Americans who buy their insurance in the individual market a breakthrough in the health care stalemate", Mr. Alexander said.

Premiums for the mid-range Silver plans sold through the exchanges would jump by 20 percent immediately, and 25 percent in the longer term. Most individuals enrolled in Obamacare plans would not feel the impact of those premium increases directly, however, because insurers would raise the cost of plans that are subsidized through a separate provision in Obamacare.

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Last Friday, the Department of Health and Human Services extended the deadline for insurance companies to decide what health plans to offer on the Obamacare exchanges and what to charge.

The decision to make this month's payment, due next week, signaled that the administration has decided against immediately precipitating a collapse, potentially giving Congress time to pass a bipartisan package of fixes to some of the law's problems. No final decisions have been made about the [cost-sharing reduction] payments. Adding to the confusion, other parts of the law clearly direct the government to reimburse the carriers.

That requirement can save thousands of dollars for families with big medical bills, especially those with low incomes, but it imposes a significant cost on insurance companies.

"The Trump administration has sent strong signals about its intent to reduce or even eliminate enforcement of the individual mandate", Pallone, the top Democrat on the House Energy and Commerce Committee, and Rep. Richard Neal (D-Mass.) wrote to General Accounting Office.

"President Trump seems to prefer playing political sabotage games over doing his job of lowering costs and improving our health care", Dach said.

In a failed attempt to drum up support for bills to repeal the Affordable Care Act this spring, Republican members of Congress repeatedly pointed to the almost 50 bare counties across the country that were at risk of having no individual health insurance options for 2018, saying they were a clear sign of Obamacare's imminent demise.

If the subsidies are canceled, some insurers could withdraw from the ACA, potentially leaving 5 percent of Americans with no insurance options for 2018, the CBO says, though insurers should adjust to the change within a couple of years.

This will be especially beneficial to enrollees slightly higher on the economic ladder, who receive subsidies but aren't eligible for cost-sharing reduction - and therefore don't have to buy Silver plans.

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